Database Development and Statistical Analysis of Survival in a Clinical and Historical Coort of Dogs Affected by Myxomatous Mitral Valve Disease Treated With Different Therapeutic Protocols Using Causal Inference Techniques

Abstract The aim of this work was to retrospectively evaluate the influence of different therapeutic protocols (loop diuretics, ACE-inhibitors, spironolactone +/- pimobendan) on the survival time (ST) of dogs with myxomatous mitral valve disease at different stages using an Inverse Probability Weighting (IPW) analysis. An IPW method was used to minimize confounding and IPW weighted time-repeated logistic model was used to approximate survival curves (SCs) and calculate survival differences. Subjects were allocated into cases (CA) and controls (CO). Dogs in American College of Veterinary Internal Medicine (ACVIM) B2 class treated with pimobendan (+/- ACE-inhibitors) were selected for the CA group, as well as symptomatic patients (ACVIM class C) threated with triple (furosemide, ACE-inhibitor, pimobendan) or quadruple (furosemide, ACE-inhibitor, pimobendan and spironolactone) therapy. The CO group included ACVIM class B2 dogs not treated with any medication and ACVIM C dogs treated with a combination of furosemide and ACE-inhibitor/spironolactone without pimobendan.The SC of the CA group crossed the CO group at 1634 days. The difference between the two SCs at the time of maximum survival difference in favour of the CO group was 11.3% (CI 1.7%–20.9%) (significant), in favour of the CA group was 3.9% (CI -8.6%–16.4%) (not significant) and at the mean ST was 3.6% (CI -8.5%–15.7%) (not significant) in favour of the CA group. For times greater than 1634 days the survival was in favour of the CA group, there were no statistically significant differences in survival in favour of the CA group in this clinical population.

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Assessment of Platelet and Plasma Serotonin in Canine Pulmonary Hypertension Secondary to Degenerative Mitral Valve Disease

Frontiers in Veterinary Science ◽

10.3389/fvets.2021.695492 ◽

2021 ◽

Vol 8 ◽

Author(s):

Nattawan Tangmahakul ◽

Pussadee Makoom ◽

Sirilak Disatian Surachetpong

Keyword(s):

Pulmonary Hypertension ◽

Mitral Valve ◽

Mitral Valve Disease ◽

High Probability ◽

Valve Disease ◽

Serotonin Concentration ◽

Platelet Serotonin ◽

The Difference ◽

Post Hoc ◽

Plasma Serotonin

Background: Pulmonary hypertension (PH) is a common complication of degenerative mitral valve disease (DMVD), the most common cardiovascular disease in dogs. Serotonin has been suspected to play a role in the pathogenesis of PH, so this study aimed to investigate the differences in platelet and plasma serotonin between normal, DMVD and DMVD with PH (DMVD+PH) dogs.Materials and Methods: Sixty-two small-breed dogs were enrolled to the study and divided into the normal (n = 22), DMVD (n = 20), and DMVD+PH (n = 20) groups. The platelet and plasma serotonin concentrations were measured by the competitive ELISA.Results: The Kruskal–Wallis revealed the difference among the four groups of normal (179.73 [102.37–352.24] ng/109 platelets), DMVD (325.99 [96.84–407.66] ng/109 platelets), DMVD with intermediate probability of PH (291.11 [106.69–400.84] ng/109 platelets) and DMVD with high probability of PH (35.82 [2.69–126.35] ng/109 platelets) (p = 0.014). The Dunn's post-hoc test showed a decrease in the platelet serotonin concentration of the DMVD dogs with high probability of PH compared to the DMVD group (p = 0.008). The plasma serotonin concentration was not different between normal, DMVD, and DMVD+PH dogs.Conclusion: In conclusion, a decrease in platelet serotonin concentration, which is associated with a degree of PH probability was found in DMVD dogs with PH. Further studies investigating roles of platelet serotonin in PH secondary to DMVD should be performed.

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